Abstract:

Presently Universal Health Care Coverage in Thailand is nearly fully financed by government general budget. UC has adopted close ended budget which come from capitation rate multiply with number of registered members. Refer to past experience, budgeting process for UC faces with annual administrative hurdle without any guarantee on adequate budget according to capitation rate calculated by cost of service and use rate. National Health Security Fund should be established by National Health Security Office and Thai citizen according to National Health Security Act B.E.2545. Major source of finance for NHSF should not be solely relied on government general budget as existing situation.Objectives of this study are to provide advantage and limitation of eight sources of finance for UC according to Article 39 in National Health Security Act B.E.2545. This study applies two methods which are brain storming of researcher team and self answering questionnaire by 20 key informants in one day workshop. The result from brainstorming of researchers indicates that contributions by local government, co-payment by patients and contributions by beneficiaries have potential to be financial sources for UC with some limitation of each source. The result from the workshop of 20 key informants reveals that political feasibility is the most important domain to decide the source of finance for UC. Other less important domains are sustainability, equity, programmatic feasibility and social acceptance the least important. The key informant workgroup have preference on Additional Taxes from Tobacco, Alcohol and Beer and clearly earmark to the fund as long as it get high score on political feasibility, social acceptance, sustainability and programmatic feasibility. On the other hand, contributions by beneficiaries are the least feasible source and it appears to be judged as social unacceptable and administrative infeasible. Increases in the VAT are deemed politically infeasible and the worst for equity reason. Questionnaires used in the workshop were originally created by researchers with foundation of knowledge and thoroughly understanding in financing of Thai health system. All key informants were fully informed in the workshop in order to have the same understanding which leads to limitation in number of valid questionnaires. However, these key informants are heath experts in Thailand from several institutions both of academic and practical organization. This study contributes new knowledge of health care financing in Thailand. Moreover, it provides fundamental information for financing the UC scheme in long run.